Malignant external otitis: Factors predicting patient outcomes

Shavit, S.S. et al. (2016) American Journal of Otolaryngology. 37(5) pp. 425–430

Objective: Malignant external otitis (MEO) is an aggressive infection, primarily affecting elderly diabetic patients. It begins in the external ear canal and spreads to adjacent structures. This study investigated the clinical characteristics of patients diagnosed and treated for MEO and analyzed factors affecting patient outcomes.

Conclusions: MEO carries a grave prognosis. The presence of two or more of the following features, DM, facial nerve palsy, positive CT scan and age above 70, predicts poor outcome, and highlights the need for prolonged, vigorous treatment.

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Cholesteatoma Definition and Classification: A Literature Review.

Rutkowska J. et al. The Journal of International Advanced Otology. Published online: 9 March 2017.

Cholesteatoma is a serious otolaryngologic condition that to date remains an important problem and poses a challenge to otolaryngologists around the world. To improve the approach pertaining to the diagnosis and management of middle ear cholesteatoma, clear, clinically applicable, and useful definition and classification of cholesteatoma are required.

This review aimed to evaluate the current and most accepted descriptions and opinions concerning cholesteatoma. A review of the literature concerning different definitions and classifications of cholesteatoma was used in the preparation of the Cholesteatoma Guidelines, a project implemented by the European Academy of Otology & Neuro-otology.

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Endoscopic tympanoplasty in the treatment of chronic otitis media: our experience.

Panetti, G. et al. (2017) Acta Oto-Laryngologica. 137(3) pp. 225-228.

Objectives: To investigate the benefits that the systematic use of endoscopy in middle ear surgery has made.

Conclusion: The endoscopy ensures good surgical exposure of hidden areas, frequently sites of residual cholesteatoma. Also, the minimally invasive endoscopic approach is more respectful of anatomy and functionality of the middle ear, restoring and preserving mastoid mucosa, with faster healing time.

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Hearing and vestibular rehabilitation, with a focus on the elderly

Fisher, E. et al. (2017) The Journal of Laryngology & Otology. 131(3) p. 189

The increasing proportion of our patients in the ‘elderly’ age group in the developed world has effects on ENT as well as every other branch of medicine. In The Journal of Laryngology & Otology in the recent past, we have looked at a variety of topics of particular interest to the otolaryngologist and geriatrician, including pharyngeal pouch, vestibular dysfunction and presbyacusis and cochlear implantation.

In this issue, an auditory brainstem response study focuses on the mechanism of hearing difficulty in the elderly, especially in noisy surroundings, comparing the elderly and young adults. This revealed significantly lower amplitudes and increased latencies in brainstem responses in the elderly, indicating that subcortical mechanisms are involved in this deficiency

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Acute Otitis Media During Infancy: Parent-reported Incidence and Modifiable Risk Factors

Prins-van Ginkel, A.C. et al. (2017) Pediatric Infectious Disease Journal. 36(3) pp. 245–249


Acute otitis media (AOM) is a common infection during infancy. By the age of 1 year, 25%–36% of children have experienced at least 1 episode of AOM and approximately 20% of children develop recurrent AOM.AOM is one of the main reasons for primary care visits, specialist referral, antibiotic consumption and surgical ear, nose and throat procedures among young children.But besides the high burden on health care, AOM also poses a high burden on parents and families; during an episode of AOM, which lasts on average 6–9 days, most parents are absent from work for 2–3 days and experience reduced quality of life because of lack of sleep and concerns about their child’s health. For these reasons, prevention of AOM is of major public health and economic importance.

With this study, we aim to determine the impact of day care attendance, breastfeeding and tobacco smoke and the effect of timing of these risk factors in the first year of life on the occurrence of AOM symptom episodes. To capture both medically and nonmedically attended AOM symptom episodes, we investigated the association between these risk factors and parent-reported AOM symptom episode occurrence in the community in a cohort of Dutch infants.

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Coping together with hearing loss

Barker, A.B. et al. International Journal of Audiology. Published online: 24 February 2017


Objective: To examine the psychosocial experiences of hearing loss from the perspectives of both the person with hearing loss and their communication partner.

Conclusions: Hearing loss affects both people with hearing loss and their communication partners. Aligned coping strategies can facilitate adjustment to hearing loss.

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Promoting global action on hearing loss: World Hearing Day

Chadha, S. & Cieza, A. International Journal of Audiology. Published online: 23 February 2017

Image source: WHO

The growing need for hearing care and a general lack of policies to address it poses a significant public health challenge. The World Health Organization aims to address this through evidence-based advocacy along with technical support to countries in provision of hearing care.

As part of its activities, WHO is promoting the World Hearing Day which is observed on 3rd March every year. The day is marked by an annual theme and release of information products and key messages. Through this, we aim to raise awareness and promote actions for ear and hearing care across the world. A large number of individuals, organisations and governments have joined this effort in order to advocate for prioritisation of hearing care.

The theme for 2017 will focus on economic aspects of hearing loss and the cost effectiveness of interventions to reduce its prevalence and impact. WHO invites all stakeholders in the field of ear and hearing care to undertake activities to mark this day and join this global initiative.

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Learn more about World Hearing Day here

Successful obliteration of troublesome and chronically draining cavities

Geerse, S. et al. (2017) The Journal of Laryngology & Otology. 131(2) pp. 138-143

This study aimed to evaluate the results of revision radical cavity surgery with mastoid obliteration using a standardised grading scheme.

A retrospective study was performed of 121 patients (122 ears) with chronically draining ears who underwent revision radical cavity surgery with mastoid obliteration between 2007 and 2013. Surgical indications, patient characteristics, pre- and post-operative Merchant grade, and surgical outcomes were recorded. The main outcome measures were presence of a dry ear, time for complete re-epithelialisation, presence of residual or recurrent disease, and need for revision surgery.

In the 5-year follow-up group (n = 31), dry ears were found in 97 per cent after 6 minor revisions and cholesteatoma-free ears were found in 97 per cent. In the total cohort, dry ears were found in 93 per cent after nine revisions and cholesteatoma-free ears were found in 98 per cent. The median time for complete re-epithelialisation was eight weeks. There were no major complications.

In terms of the dry ear rate, residual cholesteatoma and time to complete epithelialisation, revision radical cavity surgery with mastoid obliteration produces very good results in concordance with published results, despite most patients suffering from very troublesome cavities prior to surgery.

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Recurrent acute otitis media detracts from health-related quality of life

Kujala T. et al. (2017) The Journal of Laryngology & Otology. 131(2) pp. 128-137


Acute otitis media causes discomfort to children and inconvenience to their parents. This study evaluated the quality of life in children with recurrent acute otitis media aged less than 24 months.

Quality of life was evaluated in 149 children aged 10 to 24 months who were referred to the Oulu University Hospital on account of recurrent acute otitis media. The children were treated with or without surgery. Age-matched controls were selected randomly from the general child population. Parents completed the Child Health Questionnaire.

The children with recurrent acute otitis media had a significantly poorer quality of life than control children. The control children with a history of a few acute otitis media episodes had a significantly poorer quality of life than those without any such history. The quality of life of the children with recurrent acute otitis media improved during the one-year follow up, regardless of the treatment, but did not reach the same level as healthy children.

Acute otitis media detracted from quality of life when a generic measure was used. The mode of treatment used to prevent further recurrences of acute otitis media did not influence quality of life improvement.

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Otosclerosis: An update on diagnosis and treatment

Batson, L. & Rizzolo, D. (2017) Journal of the American Academy of Physician Assistants. 30(2) pp. 17–22

Image source: Batson, L. & Rizzolo, D.

Hearing loss affects the educational, psychological, and physical well-being of 360 million people worldwide. Otosclerosis, a process of progressive pathologic bone remodeling, is one of the more complex diseases that leads to hearing loss. In patients with otosclerosis, aberrant bone deposits surround and adhere to the ossicles, impairing the mechanical transmission of sound and leading to conductive hearing loss. In some patients with advanced disease, the lesions may extend into the bony labyrinth of the inner ear, affecting the cochlea and resulting in a mixed conductive and sensorineural hearing loss.

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